Strictly Financial Tax Preparation Client Intake Form

Strictly Financial Tax Preparation Client Intake Form

Thank you for choosing our tax preparation services. Please complete the following form to provide us with the necessary information for your tax preparation.
Personal Information
Full Name*

First NameMiddle NameLast NameSuffix
Date of Birth*

MonthDayYear
Social Security Number*
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Apt Number

CityState / Province

Postal / Zip CodeCountry
County of Residence
Did you live in any other state during the year?
Enter state
Do you have a personal identification number (IP PIN) from the IRS?
Enter 6 digit IP PIN
Occupation Title
Please upload valid ID

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Tax Information
Tax Year
Filing Status

SingleMarried Filing JointlyMarried Filing SeparatelyHead of HouseholdQualifying Widow(er)
Spouse Name

First NameMiddle NameLast NameSuffix
Spouse Date of Birth

MonthDayYear
Spouse Social Security Number
Spouse Email Address
example@example.com
Spouse Phone Number
Please enter a valid phone number.
Do you have a personal identification number (IP PIN) from the IRS?
Enter 6 digit IP PIN
Spouse Occupation Title
Please upload valid ID

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Additional Filing Status Questions
Were you married on December 31 of the tax year?
If married, did you live apart from your spouse for the last 6 months of the tax year?
Do you have a legal separation or divorce decree?
Did you pay more than 50% of the household expenses for your home?
Have you claimed Head of Household in previous years?
If you answered yes to the previous question, were you ever audited or questioned by the IRS about this filing status?
Can someone else claim you as a dependent?
Did a qualifying person live with you for more than half the year?
Did your spouse pass away within the last two tax years?
Additional Tax Questions
Did you or spouse receive health insurance through the marketplace?
If yes attach Form 1095-A

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Were you covered by health insurance for the entire year?
Are you or spouse permanently disabled?
Were you or your spouse a member of the Armed Forces?
Did you or spouse own, sell, or trade any cryptocurrency or digital assets?
Have you or spouse received any IRS letters or notices?
If yes, provide copies.

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Are you or spouse blind?
Do you have any dependents you would like to claim this tax year?
Dependency Information

Please provide the following dependent information for the tax year. Please provide all documents.
Dependents
Do you have custody of the dependent(s) above?
Have you been audited in previous years for claiming any of these dependents?
Please upload your dependents' social security card and birth certificates

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Income

Select all income sources you or your spouse received during the tax year. You will only be asked to upload documents that apply.
Did you make money in any other state in 2024?
Select ALL Income Sources you received

W-2 wagesSocial Security benefitsUnemployment IncomePension/Annuity IncomeSelf-employment/ independent contractor incomeInterest Income (1099-INT)Dividend Income(1099-DIV)Investment Income/ Capital Gains (1099-B)Cryptocurrency/ Digital AssetsRental IncomeRoyalty IncomeGambling/ Lottery WinningsPrize or Award IncomeAlimony ReceivedOther Income Not ListedNo Income
Upload W-2 Forms

Employment
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Upload SSA-1099, 1099-R Forms

Retirement
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Upload 1099-G

Unemployment
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Upload 1099-NEC, 1099-MISC, or other records

Self-Employment
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Upload 1099-INT, 1099-DIV, 1099-B

Investments
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Upload Crypto Transaction Report

Crypto
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Upload rental income summary

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Upload W-2G and any other income documents

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Credits

Please provide the following credit information for the tax year. Please provide all documents.
Select any tax credits that may apply

Child Tax Credit/ Credit for Other DependentsChild & Dependent Care CreditEducation credits (college or trade school)Earned Income CreditPremium Tax Credit (Marketplace insurance)Adoption CreditCredit for the elderly or disabledRetirement savings contributions creditEnergy-efficient home improvementsResidential clean energyClean vehicle credit
Did you pay for childcare during the year?
Childcare provider name
Provider EIN or SSN
Amount paid
Upload Childcare document or receipts

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Who attended school?
Was the student enrolled at least half-time?
Is this one of the first four years of higher education?
Upload Form 1098-T

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Did you incur qualified adoption expenses?
Amount paid
Upload adoption expenses

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Did you contribute to an IRA or employer retirement plan?
Upload contribution documents

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Did you make any energy-efficient or clean energy home improvements (windows, doors, or solar panels?
Amount paid
Describe improvements and date placed in service
Describe improvements and date placed in service
Upload receipts, contracts, invoices

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Did you purchase a new electric, plug-in hybrid, or hydrogen fuel cell vehicle?
Did you purchase a used clean vehicle from a licensed dealer?
Upload purchase agreement and VIN page

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Were any of these credits disallowed or reduced in a previous year?
Adjustments to Income

These items may reduce your taxable income even if you do not itemize deductions.
Select any adjustments to income that may apply

Student loan interest paidRetirement Contributions (IRS, SEP, SIMPLE)HSA ContributionsSelf-employed health insuranceEducator expensesAlimony paid (divorce finalized before 2019)
Which retirement contributions did you make?
Amount contributed
Upload contribution confirmation

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Total HSA amount contributed
Upload Form 5498-SA or year-end HSA statement

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Did you pay health insurance premiums for yourself or your family?
Total premiums paid
Upload insurance statements

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Are you an eligible K-12 educator?
Classroom expenses paid
Upload receipts

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Was your divorce or separation agreement finalized before 2019?
Total alimony paid
Upload divorce decree or agreement

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Itemized Deductions (Schedule A)

These expenses may reduce your taxable income if you decide to itemize. If your itemized deductions are more than standard deduction for the tax year we will elect to itemize deductions. Please provide all documents.
Select any itemized deductions that may apply

Mortgage Interest PaidProperty Taxes PaidState or Local Income Taxes PaidCharitable DonationsMedical ExpensesCasualty or Disaster Loss
Upload Form 1098

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Upload property tax statements

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Were state or local taxes withheld from your wages or paid during the year?
Approximate total cash donations made
Form 1098
Did you donate non-cash items?
Upload donation receipts or letters

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Upload medical expense summary or receipts

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Was this a federally declared disaster?
Upload insurance or disaster documents

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Did you pay any estimated tax during the year?
If yes, how much?
Do you have any previous unfiled tax returns?
Advances
Are you interested in applying for a refund advance?
Important Disclosure:

A refund advance is an optional loan offered by a third-party bank. The APR is 35.99%. Approval is not guaranteed. This loan is repaid from your tax refund. You are not required to take a refund advance to use our tax preparation services
Select the refund advance amount you wish to apply for

$500$1,000$1,500$2,000$3,000$4,500$6,000
Payment & Refund Options

Choose how you would like to pay for your tax preparation services and receive your refund.
Payment & Refund Transfer Policy:

If you choose to pay your tax preparation fees from your refund, a Refund Transfer fee of $211.90 will be deducted from your refund in addition to your tax preparation fees.

Prior year returns, amended returns, and returns that result in a balance due must be paid upfront and are not eligible for refund advances or refund-based payment options. Payment is required before return is filed.
How would you like to pay for your tax preparation services?

Pay UpfrontPay from refund
How would you like to receive your refund?

Direct depositPrepaid debit card
Direct Deposit Information

Please provide the following direct deposit information for the tax year.
Bank Name
Type of Account
Routing Number
Re-enter Routing Number
Account Number
Re-enter Account Number
Document Checklist

To ensure your tax return is prepared accurately and in full compliance with IRS requirements, please attach applicable documents from the checklist below. This checklist covers a range of possible documentation for verifying eligibility for credits and deductions. While not all items may apply to your situation, please submit any documents that are relevant to your specific tax circumstance. Attach additional documents that are not listed but may support or impact your tax return.
1. Identity and Relationship Verification
Required to confirm the taxpayer’s identity and relationship to dependents.
- Government-Issued Photo ID (Driver’s License, State ID, Passport)
- Social Security Cards (For taxpayer, spouse, and dependents)
- Individual Taxpayer Identification Number (ITIN) Letter (if applicable)
- Birth Certificates (For dependents)
- Adoption Records or Legal Guardianship Papers
2. Filing Status Verification

Proof to support the taxpayer’s chosen filing status (Single, Head of Household, Married Filing Jointly, etc.).

Head of Household (HOH):
- Lease or utility bills showing taxpayer and dependent at the same address
- School or medical records for dependents (showing address)
- Proof of household expenses paid by the taxpayer (rent, utilities, groceries)
Married Filing Jointly/Separately:
- Marriage certificate (if newly married)
- Divorce decree or separation agreement (if separated)
Qualifying Widow(er):
- Spouse’s death certificate
- Proof of dependent child in the household
3. Earned Income Credit (EIC) Verification
Proof of earned income and residency for claiming the EIC.
- W-2 Forms from employers
- 1099-NEC/K (for self-employment income)
- Business income records (invoices, receipts)
- School records, medical records, or daycare records with the child’s address
- Lease agreements or utility bills showing dependent’s residency
4. Child Tax Credit (CTC) & Additional Child Tax Credit (ACTC)
Proof of relationship, residency, and support for qualifying children.
- Birth certificates or adoption papers
- Social Security cards for dependents
- School, medical, or daycare records showing residency
- Proof the taxpayer provided more than half of the child’s support
5. Child and Dependent Care Credit
Documentation for claiming dependent care expenses.
- Provider’s name, address, and Tax ID number (EIN or SSN)
- Receipts or statements showing payments made for childcare or adult care
6. Education Credits (AOTC & Lifetime Learning Credit)
Proof of qualified education expenses.
- Form 1098-T (Tuition Statement) from the educational institution
- Receipts for tuition, fees, and required course materials
- Proof of student enrollment status (full-time/part-time)
7. Self-Employment Income and Expenses (Schedule C)
Proof of business income and deductible expenses.
- 1099-NEC/K forms (contract work or third-party payments)
- Profit and loss statements
- Business Income and expense summary
- Receipts for business expenses (supplies, advertising, office rent)
- Mileage logs and vehicle expenses (if applicable)
- Home office expenses (utilities, rent/mortgage, internet)
8. Health Coverage (Affordable Care Act - ACA)
Proof of health insurance coverage and payments.
- Form 1095-A (Marketplace Coverage)
- Form 1095-B/C (Employer or other health coverage)
Records of monthly health insurance payments

9. Retirement Contributions
Proof of contributions to retirement accounts.
- Form 5498 (IRA Contributions)
- Contribution statements for 401(k), 403(b), or other retirement plans
- Documentation for self-employed retirement plans (SEP IRA, SIMPLE IRA)
10. Energy-Efficient Home and Vehicle Credits
Proof of qualified energy-saving improvements and electric vehicle purchases.

Residential Energy Credit:
- Receipts for energy-efficient appliances, windows, doors, solar panels
- Manufacturer’s certification statement
Clean Vehicle Credit:
- Purchase agreement for an electric/hybrid vehicle
- Manufacturer’s certification of eligibility
11. Charitable Contributions
- Proof of donations to qualified charitable organizations.
- Receipts or letters from charitable organizations for donations over $250
- Bank/credit card statements for cash donations
- Valuation documentation for non-cash donations (clothing, goods)
12. Homeownership Credits and Deductions
- Proof of mortgage interest and property tax payments.
- Form 1098 (Mortgage Interest Statement)
- Property tax bills and payment receipts
- Closing disclosure or settlement statement (for home purchases)
13. State and Local Tax (SALT) Deduction
- Proof of eligible state and local tax payments.
- State income tax payment records
- Property tax bills
- Vehicle registration fees
14. Miscellaneous Credits and Deductions
Proof for other available credits and deductions.

Adoption Credit: Legal adoption paperwork, receipts for expenses
Student Loan Interest Deduction: Form 1098-E
Medical Expenses: Bills and receipts for qualified medical costs
Alimony Paid (for pre-2019 agreements): Divorce decree, payment records
File Upload

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Taxpayer Certification
I certify that the information provided is accurate and complete to the best of my knowledge.
Date*

MonthDayYear
Date
Taxpayer Signature

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Spouse Signature

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Strictly Financial Tax Preparation Client Intake Form

Personal Information

Tax Information

Additional Filing Status Questions

Additional Tax Questions

Dependency Information

Income

Credits

Adjustments to Income

Itemized Deductions (Schedule A)

Advances

Payment & Refund Options

Direct Deposit Information

Document Checklist

Taxpayer Certification